Gynecomastia Surgery in Mumbai

Gynecomastia is the enlargement of male breast tissue caused by an imbalance between estrogen and testosterone. It is one of the most common conditions in men, affecting teenagers during puberty, adults, and older men. The enlargement can involve glandular breast tissue, fat, or both. The specific composition determines the appropriate surgical technique.

Gynecomastia is not the same as chest fat from being overweight. True gynecomastia involves actual glandular breast tissue beneath the nipple that feels firm or rubbery on examination. This glandular tissue does not respond to diet or exercise. It is structurally identical to female breast glandular tissue and can only be removed surgically. Pseudogynecomastia, by contrast, is caused by fat accumulation without significant glandular tissue and is more common in overweight men. Mixed gynecomastia, the most common presentation, involves both glandular tissue and fat.

Dr. Vicky Jain performs gynecomastia surgery for men across all grades of the condition. The procedure combines liposuction for the fat component with direct gland excision for the glandular component, producing a flat, masculine chest contour with minimal scarring and permanent results.

Surgery takes 1 to 2 hours under local or general anesthesia depending on the grade of gynecomastia and patient preference. Most patients go home the same day. Dr. Jain first performs liposuction of the chest through small access points to remove the fat component and reduce the overall chest volume. The liposuction is performed with a thin cannula passed through 3 to 4 millimeter access points that leave virtually invisible scars.

After liposuction, a small semicircular incision is made at the lower border of the areola, within the natural pigmented boundary of the areola-skin junction where it is least visible. Through this incision, the glandular tissue is directly visualized and excised in its entirety. The firmness of the tissue, visible to the surgeon under direct vision, guides the extent of excision. Tissue is removed until the nipple and areola sit flat against the chest wall with no residual disc of firm tissue palpable beneath them.

The incisions are closed with fine sutures. A compression garment is applied in the operating room before the patient wakes. The garment is worn continuously for 4 to 6 weeks. The removed glandular tissue is sent for histological analysis at every case. Results confirming benign breast tissue are reviewed at the post-operative visit.

Good candidates are men with gynecomastia that has persisted for more than 1 year, has not responded to conservative measures, and is causing cosmetic concern or psychological distress. The condition should be stable, meaning it has not been changing rapidly in size. Patients should be at or near a stable weight, as significant weight gain after surgery will add fat to the chest even after gland removal.

Teenagers with gynecomastia are appropriate candidates for surgery if the condition has persisted beyond puberty, typically more than 2 years after onset, and is not resolving. There is no advantage to waiting longer beyond this point in persistent pubertal gynecomastia. Patients who are using anabolic steroids should stop their use before surgery, as continued steroid use after gland excision can stimulate residual tissue and cause recurrence. Patients with medical causes of gynecomastia should have those conditions assessed and managed before or alongside the surgical treatment.